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CPT 28415: Open Surgical Treatment of Calcaneal Fracture
CPT code 28415 denotes open surgical treatment of calcaneal (heel bone) fractures, performed with or without internal fixation such as screws or nails. This operative code captures definitive surgical management of displaced or unstable calcaneal fractures and is used across hospital operating rooms and ambulatory surgery centers. It is clinically significant because calcaneal fractures can lead to long-term disability, complex reconstruction needs, and substantial variation in resource use and post-operative care.
Key payers discussed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a national-level overview of coding intent and clinical context, common billing and site-of-service considerations, and what to expect in terms of service classification. The publication covers typical utilization benchmarks, payment policy features that affect coverage for operative fixation versus nonoperative care, and operational coding notes relevant to hospital and ambulatory surgical settings.
This summary is designed to help coders, billing managers, and clinical leaders quickly understand where CPT code 28415 fits in surgical foot and ankle care, how it impacts service lines, and which policy and billing topics to review for compliance and revenue cycle management. Data not available in the input is noted where applicable.
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Billing Code Overview
CPT code 28415 describes an open surgical treatment of a calcaneal (heel bone) fracture, with or without internal fixation using implants such as screws or nails. This procedure involves direct exposure of the fracture site to anatomically reduce and stabilize the calcaneus.
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Service type: Open surgical fracture treatment of the calcaneus
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Typical site of service: Inpatient or outpatient hospital operating room or ambulatory surgery center, depending on clinical complexity and patient needs